AR Manager

Summary

As an AR Manager you should have end to end knowledge of RCM and Medical Billing. Must be capable of handling the team and analyzing the status of claims for the outstanding balances on patient accounts and taking appropriate actions. Manage A/R accounts by ensuring accurate and timely follow-up. Ensure that the deliverable to the client adhere to the quality standards

What you'll do

• • Train associates on AR and identify improvement areas 
  • Allocate accounts to team members  
  • Review denial and AR reporting (Waystar)
  • Analysis / insights about root cause of denials  
  • Monitor denial trends by reason, payer, CPT, etc.
  • Establish relationships with payer stakeholders (director level) to discuss issues / non payment  
  • Lead weekly CI meetings to:
    • Credentialing
    • Clinics not responding  
    • Timely filing denials
    • Present AR and denials status along with insights
    • Escalate issues related to payers (I.e., we need help with this payer because X, here are examples)
    • Escalate issues related to clinic ops
  • Maintain project-related documents (SOPs, training materials, workflows)

What you have

• Any Degree
• Experience working AR
• Experience leading teams and leading team leads (leading leaders)
• Understanding of California / IPA payer landscape
• Experience with contracts
• Experience calling payers / establishing relationships with payer stakeholders
• Communication / presentations skills
• Analytic mindset
• Experience documenting materials / SOP
• At least 10 years experience in RCM
• Knowledge of Healthcare terminology and ICD/CPT codes will be considered a plus

KPIs for performance

• AR Days
• Repeated Denials
• Denial follow-up turnaround time
• Indirect: denial rates should be decreasing